January 26, 2010
Demonstrating that the burden of neglected tropical diseases (NTDs) is not just dependent on climate, but mainly related to incidence of poverty, a new paper published in the open-access journal PLoS Neglected Tropical Diseases details the large number of neglected infections of poverty in the Arctic region and calls for greater research into these devastating, debilitating and sometimes deadly diseases in the region.
“One of the most dramatic illustrations of poverty as the single most important determinant of neglected infections among human populations is the observation that these conditions occur among the poorest people in the Arctic region,” states the paper’s author, Dr. Peter Hotez, President of the Sabin Vaccine Institute and Distinguished Research Professor at George Washington University. Hotez notes that there are a dozen neglected infections of poverty in the region, most of which are foodborne.
There are seven countries with significant territory in the Arctic, including Canada, Finland, Greenland, Norway, Russia, Sweden and the United States (Alaska). Iceland is also sometimes included in the definition of the Arctic. Approximately two million people live north of the Arctic Circle, with 60% living in Arctic Russia. A high percentage of these populations represent aboriginal or indigenous peoples. In Canada, the most indigenous people of the Arctic are the roughly 50,000-60,000 Inuit.
Dr. Hotez notes that it is not surprising that neglected infections of poverty are found in the Arctic given the region’s socioeconomic deprivation, stress, and environmental degradation. Indigenous people living in the Arctic region suffer disproportionately from high rates of chronic conditions such as smoking, drinking and obesity and have a life expectancy 8-12 years shorter than the non-indigenous population. “Indeed, overall the world’s indigenous people in general suffer from high rates of infections such as ectoparasitic skin infestations, upper and lower respiratory track infections, and central nervous system infections from bacterial invasive organisms and tuberculosis, childhood illnesses, diarrheal and intestinal helminth infections, urinary tract infections, bone and musculoskeletal infection and in some cases, HIV/AIDS and malaria,” Hotez stated.
Many of the parasitic infections are foodborne and transmitted through uncooked or inadequately prepared meats from polar bear and sea mammals such as walrus or seal. Other infections are zoonoses (diseases that can be transmitted from animals to humans) transmitted from livestock unique to the Arctic region such as reindeer and elk.
Toxoplasmosis is one of the neglected infections of poverty endemic to the Arctic region. In terms of prevalence and diseases burden, toxoplasmosis is probably the most important parasitic infection in the North American Arctic. Toxoplasmosis can seriously impact people with a weakened immune system. The parasite can also cause encephalitis, neurologic diseases and can also affect the heart, liver and eyes. “Given the high rates of toxoplasmosis, a program of newborn screening for these populations would identify at-risk infants eligible for antiprotozoan chemotherapy,” Hotez concludes.
Dr. Hotez also concludes that further study is needed of neglected infections of poverty throughout the Arctic region, including among the indigenous populations living in Russia and Siberia. “Ultimately, programs for prevention of neglected infections may need implementation for all of the indigenous people living in the Arctic region,” Hotez states.